Insurance Fraud Prosecutions and Schemes
Fraud runs from the opportunistic single claim to organised rings operating across states. This category collects indictments, convictions, department-of-insurance enforcement actions and the scheme patterns that special investigation units are seeing.
- US prosecutors focus on four businesses tied to billionaire ...
U.S. federal prosecutors and the SEC are investigating four businesses tied to billionaire Mark Walter’s empire, the Wall Street Journal reported. The inquiry centers on whether Walter or his companies concealed financial ties while borrowing billions from insurers he controls. The report said loan proceeds passed through entities linked to the four firms before being used for other Walter-linked businesses.
- Lindberg's Right-Hand Man Sentenced to Two Years After Cooperating With Prosecutors
Christopher Herwig, Greg Lindberg’s former chief investment officer, was sentenced in the Western District of North Carolina to two years in prison and ordered to forfeit $842,000. He had pleaded guilty in 2022 in a related case and was sentenced after Lindberg’s prosecution was completed. Lindberg is serving a 12-year federal sentence for bribery and a multibillion-dollar insurance fraud scheme.
- Murder-for-hire trial tied to staged crash scheme begins
A federal murder-for-hire trial opened in New Orleans on August 12 for disbarred attorney Sean Alfortish and Leon Parker. Authorities say Alfortish paid Parker to kill Cornelius Garrison after learning Garrison was cooperating with the FBI in the staged-crash insurance fraud probe known as Operation Sideswipe. Garrison was shot and killed in September 2020.
- DOJ Charges 11 Defendants in Connection with $2 Billion ...
The Justice Department charged 11 defendants in connection with more than $2 billion in fraudulent amniotic wound allograft claims on June 23, 2026. Prosecutors allege the schemes used kickbacks, medically unnecessary procedures and elderly Medicare and hospice patients. One Arizona case involved a former sales vice president tied to a $1.2 billion scheme.
- Report: Man Accused of Faking COVID-19 Tests to Get Comp Benefits
The New York State Inspector General charged a Staten Island man with workers’ compensation fraud, according to a report cited by the item. Prosecutors said he allegedly faked positive COVID-19 tests to collect benefits. No additional case details were provided.
- SF Contractor Couple Charged in Alleged Workers' Comp Fraud Scheme Involving an Injured Worker
San Francisco construction owners Declan and Grace McKevitt were arraigned August 7 on felony fraud charges. Prosecutors say An Dun Construction underreported payroll to its insurer and the state, then pressured an injured worker who lost a finger to lie about how it happened. The alleged conduct delayed the worker’s benefits for four months.
- Contractors Arraigned On Charges Of Fraud - San Francisco News
San Francisco prosecutors arraigned Declan McKevitt, 47, and Grace McKevitt, 54, on felony charges tied to workers’ compensation premium fraud and payroll tax fraud. Officials say the couple, who own An Dun Construction, underreported payroll and failed to pay premiums, taxes and required contributions. Declan also faces charges over allegedly denying an injured worker’s claim.
- South Florida residents among 7 accused in $100 million workers’ comp scheme
Five South Florida residents are among seven people accused in a nearly $100 million workers’ compensation fraud scheme, according to state officials. Prosecutors say shell companies were used to obtain insurance by significantly underreporting employee counts and payroll. The investigation began in December 2024 after detectives flagged JYK Construction Concrete Inc. in West Palm Beach.
- White Collar : Law360 : Legal News & Analysis
A former top aide to convicted insurance mogul Greg Lindberg was sentenced to two years in federal prison for taking part in a $2 billion fraud scheme. Prosecutors said the scheme defrauded thousands of policyholders. In a separate case, Manhattan federal prosecutors charged 11 people in a decade-long sham-marriage scheme tied to immigration fraud.
- Prosecutors say a hit man killed a federal witness tied to staged 18-wheeler crashes
Federal prosecutors in New Orleans accused Sean Alfortish, a disbarred attorney, of conspiring to kill cooperating witness Cornelius Garrison in a case tied to staged 18-wheeler crashes. The broader probe has charged 63 defendants and involves fraud, obstruction, witness tampering and insurance claims tied to deliberate collisions from 2011 through 2024.
- 5 local people among 7 charged in alleged $100M Florida workers' comp fraud scheme
Florida Attorney General James Uthmeier announced charges against seven people in an alleged workers' compensation fraud and unlicensed money-service scheme that processed nearly $100 million. Five defendants were from Palm Beach County or the Treasure Coast, and investigators said the group used shell construction companies, rented insurance certificates to subcontractors and cashed payroll checks through an illegal operation.
- A May jury convicted a man who sold annuities after losing his insurance license and pocketed $88,000 - The Financial Wire
A Baltimore County jury convicted Michael Okolo of 10 felony insurance-fraud counts for acting as an agent without a license. Prosecutors said he kept selling annuities from 2021 through 2024 after his license was revoked in 2019 and collected more than $88,000 in commissions.
- SEC Bars 2 Imprisoned Brokers Tied To Sweeping $115M Ponzi Fraud
The SEC said Christopher Parris and John Piccarreto, two former Rochester, New York, brokers, agreed to be barred from the securities industry after a decade-long Ponzi scheme that took in more than $115 million. Prosecutors said the group persuaded investors to move savings into entities they controlled with false claims about businesses in financial services, insurance, real estate development and medical laboratories. Both men had pleaded guilty in 2021.
- Gainesville Real Estate Broker Arrested For Insurance Fraud
Niya Curinton Dix, a 50-year-old Gainesville real estate broker, was arrested on multiple felony charges in an alleged insurance fraud scheme. Authorities said the case began after her ex-husband discovered a suspicious claim filed under his name. She was booked into the Alachua County Jail on five charges, including insurance fraud under $20,000, forgery, identity use and unlawful use of a two-way communications device.
- Prosecutors charged schemes worth a half-billion dollars in April that looted Medicare and pandemic-aid programs
The Justice Department said an April enforcement package involved more than $500 million in attempted health-care billing, pandemic tax credits and related losses. Prosecutors said one matter centered on alleged insurance-marketing companies that enrolled consumers in Affordable Care Act plans without consent, causing about $141.5 million in unwarranted tax credits and subsidies.…
- Employer Fraud is Alive and Well | Workers Compensation Columns
A workers’ compensation column says employer fraud can far exceed claimant fraud, citing Texas Mutual Insurance Co. data showing premium fraud losses in the millions. The article says a roofing company in Orange County, California, had owners arrested on 106 felony counts and charged with $38 million in workers’ compensation fraud. It also says premium fraud includes misclassifying workers, underreporting payroll or failing to buy coverage.
- Silver Spring Woman Sentenced to More Than Three Years in Federal Prison for Role in COVID Fraud Scheme
Elizabeth Maria Ceballos, 50, of Silver Spring, Maryland, was sentenced in federal court to 40 months in prison for an unemployment insurance fraud conspiracy tied to the COVID era. Prosecutors said she and Vanessa Valdez fabricated false tax documents for claims submitted to the Maryland Department of Labor from at least May 2020 through September 2021. The court also ordered Ceballos to pay $638,889 in restitution.
- Wmata Train Operator Sentenced In $360K AFLAC Fraud
WMATA train operator Michelle Shropshire was sentenced to 24 months in federal prison for leading a four-year AFLAC fraud scheme. Prosecutors said she recruited coworkers, forged doctors' signatures, and helped file false disability and health care claims that cost AFLAC at least $362,035.14. She was ordered to pay restitution and forfeiture, and six other WMATA employees have pleaded guilty in related cases.
- Insurance magnate pleads guilty to fraud scheme - Spectrum News
Insurance magnate Greg E. Lindberg pleaded guilty in Charlotte to conspiracy to commit offenses against the United States and conspiracy to commit money laundering. Prosecutors said he helped run a roughly $2 billion scheme that defrauded insurance regulators, policyholders, and others through companies he controlled. The case stemmed from conduct between 2016 and 2019, and Lindberg was already awaiting sentencing in a separate bribery case.
- Brian Rowan Penalties Could Be Severe If Convicted of Healthcare Fraud, Kickbacks, and Wire Fraud Conspiracy
Brian Rowan could face decades in prison if convicted in the alleged $1.2 billion wound-allograft fraud case. Federal prosecutors say the former sales executive is charged with healthcare fraud, wire fraud, kickbacks, conspiracy and money laundering tied to false claims submitted to Medicare, TRICARE, CHAMPVA and commercial insurers. They allege the scheme generated about $614 million in payments and involved hundreds of millions in kickbacks and other incentives.
- Travel-insurance fraud brings $1.2 million restitution and eight sentences
Eight people were sentenced after a travel-insurance employee turned claims knowledge into a $1.2 million fraud conspiracy. Prosecutors said Jennifer Fleener recruited relatives, colleagues and associates to buy policies without intending the travel described and then filed or approved fabricated claims. The group pleaded guilty to conspiracy to commit mail and wire fraud, and the largest restitution order was $1,199,149.32.
- Federal Insurance Fraud Defense - White Collar Crime Lawyer
Federal insurance fraud can be charged when a scheme crosses state lines through the mail or interstate wires, or when it falls under 18 U.S.C. § 1033. Prosecutors must prove a scheme and specific intent to defraud, not just a disputed or overstated claim. Mail and wire fraud can bring up to 20 years per count, while § 1033 offenses generally carry up to 10 years, or 15 years if an insurer’s solvency is jeopardized.
- Workers Compensation Fraud - Nevada Laws & Penalties
Nevada treats workers’ compensation insurance fraud as intentionally providing false information to obtain benefits not owed. The offense is usually prosecuted as a category D felony, punishable by one to four years in state prison and possible fines of up to $5,000. The state says fraud cases are overseen by the Department of Business and Industry and prosecuted by the Attorney General’s Workers Compensation Unit.
- SLED Charges Final Subject in Insurance Fraud Investigation
South Carolina authorities charged Matthew Jo Von Coaxum, 45, with forgery and presenting a false claim for insurance payment valued at $10,000 or more. The South Carolina Department of Insurance requested the SLED investigation, and Coaxum was booked into the Alvin S. Glenn Detention Center in Richland County. Two others, Zanajia Wilson-James and Tikia Simone Carter, were previously charged in the case.